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A Knowledge, Attitude and Practices study among nurses in ICU & RDU about universal precautions in Riyadh hospitals, 2003.


Between 5% and 10% of patients admitted to acute care hospitals acquire one or more nosocomial infections, with the risk has steadily increasing from 7.2 in 1975 to 9.8 in 1995. Standard precautions represents a system of barrier precautions to be used by all personnel for contact with blood, all body fluids, secretions, excretions, non-intact skin, and mucous membranes of all patients, regardless of the patient's diagnosis. We assessed the actual practices of nurses plus their knowledge and attitude towards hand-washing and universal precautions in the intensive care units (ICU) and renal dialysis units (RDU) of two hospitals in Riyadh, Saudi Arabia.


We conducted a cross-sectional study involving observation of the practices of 60 nurses in the ICU and RDU of two hospitals on alternate days over 4 weeks. After the observation period, nurses working at these units were given a questionnaire assessing their knowledge and attitudes.


Of 906 procedures observed, nurses washed their hands in 17% prior to or after the procedure. Hand-washing was more frequent among ICU workers (27%) than BDU (7.4%). The percentage of wearing gloves was 31%. Wearing gowns was consistently practiced in both units (99.7% of procedures). Nurses wore a mask in 72% of procedures, and this was much higher in one hospital (95%) than the other (47%). 10% of procedures required mandatory use of a face shield, but these were not used. Correct disposal of sharps occurred in 99.7% of 315 procedures in which they were used. Contaminated items were correctly disposed of in 34% of 463 instances, and non-contaminated items in 39% of 195. The overall scoring of the knowledge and attitude in both hospitals was fair.


We conclude that the application of universal precautions in ICU and RDU was below the ideal standards in both hospitals. Regarding knowledge and attitude about infection control precautions, it was found that nurses in both hospitals require more health education about universal precautions.